Distribution and Selected Beta-Lactam Susceptibility of Escherichia coli and Staphylococcus aureus in Suspected Sepsis Patients at RSUD Ir. Soekarno
DOI:
10.29303/jbt.v26i3.12055Published:
2026-07-06Downloads
Abstract
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection, and antimicrobial resistance may compromise empirical therapy. This retrospective descriptive study described the distribution of Escherichia coli and Staphylococcus aureus and selected beta-lactam susceptibility patterns among patients with suspected sepsis at RSUD Ir. Soekarno Sukoharjo during 2024–2025. Secondary data from blood, urine, sputum, and pus cultures, including antimicrobial susceptibility testing using the VITEK 2 Compact system, were analyzed descriptively as counts and proportions. Escherichia coli accounted for five isolates in 2024 and four in 2025, whereas Staphylococcus aureus was represented by one isolate in 2024 and was not identified in 2025. Resistance to ceftazidime was observed in 3/5 (60.0%) Escherichia coli isolates in 2024 and 3/4 (75.0%) in 2025, while ceftriaxone resistance occurred in 4/5 (80.0%) and 3/4 (75.0%), respectively. The single Staphylococcus aureus isolate was resistant to oxacillin and phenotypically consistent with MRSA. These findings indicate frequent resistance to third-generation cephalosporins among a small number of Escherichia coli isolates. Interpretation should be cautious because of the limited number of isolates and the absence of confirmatory ESBL or MRSA testing data.
Keywords:
Antibiotic Escherichia coli Methicillin-resistant Staphylococcus aureus Sepsis Third-generation cephalosporinsReferences
Ariyanti, T., Suhaemi, S., Mulyati, S., Sukatma, S., Sumirah, S., Noor, S.M., Rachmawati, F., Widiyanti, P.M., Sukmawinata, E. & Andriani, A. (2025) Dissemination and phenotypic characterization of ESBL-producing Escherichia coli in Indonesia. Open Veterinary Journal, 15(3), 1340.
Baur, D., Gladstone, B.P., Burkert, F., Carrara, E., Foschi, F., Döbele, S. & Tacconelli, E. (2017) Effect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infection: a systematic review and meta-analysis. The Lancet Infectious Diseases, 17(9), 990–1001.
BioMérieux. (2023) VITEK® 2 Systems: Product Information and User Manual. Marcy-l'Étoile, France: BioMérieux.
Bush, K. & Bradford, P.A. (2016) β-Lactams and β-lactamase inhibitors: an overview. Cold Spring Harbor Perspectives in Medicine, 6(8), a025247.
Cecconi, M., Evans, L., Levy, M. & Rhodes, A. (2018) Sepsis and septic shock. The Lancet, 392(10141), 75–87.
Centers for Disease Control and Prevention (CDC). (2022) Laboratory testing for methicillin-resistant Staphylococcus aureus (MRSA). Atlanta, GA: CDC.
Chang, Y., Oh, J.H., Oh, D.K., Lee, S.Y., Hyun, D., Park, M.H. & Lim, C.M. (2024) Culture-negative sepsis may be a different entity from culture-positive sepsis: a prospective nationwide multicenter cohort study. Critical Care, 28(1), 385.
Clinical and Laboratory Standards Institute (CLSI). (2023) Performance Standards for Antimicrobial Susceptibility Testing. 33rd ed. CLSI Supplement M100. Wayne, PA: CLSI.
Di Franco, S., Alfieri, A., Pace, M.C., Sansone, P., Pota, V., Fittipaldi, C., Fiore, M. & Passavanti, M.B. (2021) Blood stream infections from MDR bacteria. Life, 11(6), 575.
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C.M., French, C., Machado, F.R., McIntyre, L., Ostermann, M. & Prescott, H.C. (2021) Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2021. Critical Care Medicine, 49(11), e1063–e1143.
Gul, F., Arslantas, M.K., Cinel, I. & Kumar, A. (2017) Changing definitions of sepsis. Turkish Journal of Anaesthesiology and Reanimation, 45(3), 129–138. https://doi.org/10.5152/TJAR.2017.93753
Holmes, C.L., Anderson, M.T., Mobley, H.L.T. & Bachman, M.A. (2021) Pathogenesis of Gram-negative bacteremia. Clinical Microbiology Reviews, 34(2), e00234-20.
Klinker, K.P., Hidayat, L.K., DeRyke, C.A., DePestel, D.D., Motyl, M. & Bauer, K.A. (2021) Antimicrobial stewardship and antibiograms: importance of moving beyond traditional antibiograms. Therapeutic Advances in Infectious Disease, 8, 1–10.
Logan, L.K. & Weinstein, R.A. (2017) The epidemiology of carbapenem-resistant Enterobacteriaceae: the impact and evolution of a global menace. The Journal of Infectious Diseases, 215(Suppl 1), S28–S36.
Nabila, N., Bramantono, B., Kusumaningrum, D. & Widodo, A.D.W. (2024) Pola kuman serta kepekaan antibiotik pada pasien sepsis di ruang rawat inap penyakit dalam RSUD dr. Soetomo Surabaya. Syntax Literate: Jurnal Ilmiah Indonesia, 9(8), 4562–4571. https://doi.org/10.36418/syntax-literate.v9i8.17294
Niederman, M.S., Baron, R.M., Bouadma, L., Calandra, T., Daneman, N., De Waele, J., Kollef, M.H., Lipman, J. & Nair, G.B. (2021) Initial antimicrobial management of sepsis. Critical Care, 25(1), 307.
Nugraheni, A.Y., Putri, M.S. & Saputro, A.Y. (2021) Evaluasi ketepatan antibiotik pada pasien sepsis. Pharmacon: Jurnal Farmasi Indonesia, 18(2), 194–207. https://doi.org/10.23917/pharmacon.v18i2.16635
Paluch, M., Lleres-Vadeboin, M., Poupet, H., Chanard, E., Wilhelm, N., Nadji, S., Prots, L., Bala, Y., Zambardi, G. & Cattoen, C. (2023) Multicenter evaluation of rapid antimicrobial susceptibility testing by VITEK® 2 directly from positive blood culture. Diagnostic Microbiology and Infectious Disease, 106(3), 115950.
Pulido, M.R., García-Quintanilla, M., Martín-Peña, R., Cisneros, J.M. & McConnell, M.J. (2021) Rapid antimicrobial susceptibility testing methods for blood cultures and their clinical impact. Frontiers in Medicine, 8, 635831.
Raudah, S. & Damayanti, F. (2022) Pemeriksaan kultur darah dengan menggunakan alat VITEK 2 Compact Laboratorium Mikrobiologi RSUD Abdoel Wahab Sjahranie Samarinda. Jurnal Teknologi Laboratorium Medik Borneo, 2(1), 8–16. https://doi.org/10.35728/jutelmo.v2i1.1065
Scheer, C.S., Annane, D., Artigas, A., Linder, A., Sander, M., Demirkiran, O., Reinhart, K. & Giamarellos-Bourboulis, E.J. (2025) Infrastructure and current practice of blood culture diagnostics in patients with sepsis: teachings and recommendations from the European Sepsis Care Survey. Critical Care, 29(1). https://doi.org/10.1186/s13054-025-05582-6
Singer, M., Deutschman, C.S., Seymour, C.W., Shankar-Hari, M., Annane, D., Bauer, M., Bellomo, R., Bernard, G.R., Chiche, J.D., Coopersmith, C.M., Hotchkiss, R.S., Levy, M.M., Marshall, J.C., Martin, G.S., Opal, S.M., Rubenfeld, G.D., van der Poll, T., Vincent, J.L. & Angus, D.C. (2016) The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 315(8), 801–810. https://doi.org/10.1001/jama.2016.0287
Tong, S.Y.C., Davis, J.S., Eichenberger, E., Holland, T.L. & Fowler, V.G. Jr. (2015) Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clinical Microbiology Reviews, 28(3), 603–661.
Wahyuni, W., Nurahmi, N. & Rusli, B. (2018) Pattern of Bacteria and Its Antibiotic Sensitivity in Sepsis Patients. Indonesian Journal of Clinical Pathology and Medical Laboratory, 23(1), 80–83. https://doi.org/10.24293/ijcpml.v23i1.1189
World Health Organization (WHO). (2020) Global Report on the Epidemiology and Burden of Sepsis: Current Evidence, Identifying Gaps and Future Directions. Geneva: World Health Organization.
World Health Organization (WHO). (2023) Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report. Geneva: World Health Organization.
License
Copyright (c) 2026 Yusianti Silviani, Mustofa Tri Wijayanto
This work is licensed under a Creative Commons Attribution 4.0 International License.
Jurnal Biologi Tropis is licensed under a Creative Commons Attribution 4.0 International License.
The copyright of the received article shall be assigned to the author as the owner of the paper. The intended copyright includes the right to publish the article in various forms (including reprints). The journal maintains the publishing rights to the published articles.
Authors are permitted to disseminate published articles by sharing the link/DOI of the article at the journal. Authors are allowed to use their articles for any legal purposes deemed necessary without written permission from the journal with an acknowledgment of initial publication to this journal.
